Knowledge & Information Distribution Site (KIDS)

DCF Circuit 15

Dennis Miles
DCF Regional Managing Director
Circuits 15, 17 & 19
111 S. Sapodilla Ave.
West Palm Beach, FL  33401
(561) 837-5078

Elisa Cramer
DCF Circuit Community Development Administrator
111 S. Sapodilla Ave.
West Palm Beach, FL 33401
(561) 227-6686

Robert Shea
Director of Family & Community Services
111 S. Sapodilla Ave.
West Palm Beach, FL 33401
Cell: (772) 216-3300
Office: (561) 227-6668

Amy Gregory
DCF Regional Family Safety Operations Manager
Circuits 15 & 19
111 S. Sapodilla Ave.
West Palm Beach, FL 33401
Cell: (772) 577-0311

Larry Rein CEO & President
ChildNet Palm Beach
4100 Okeechobee Blvd.
West Palm Beach, FL 33406
(561) 352-2500

Facility Intake Packets

A Place of Hope - Shelter

A Place of Hope - Cottage for Girls

Genesis Placement Agreement

Grandma's Place

Hibiscus Children's Center - Vero Beach

Hibiscus House - Jensen Beach

Kids In Distress - Wilton Manors

Seven Stars Place of Hope for Boys

The Grove

The Haven

Vision Quest

File Jacket Forms

Acknowledgement Form (All Pamphlets and Brochures)

Chronological Notes

CPI Rights and Responsibilites

CPI Rights and Responsibilites - Creole

CPI Rights and Responsibilites - Spanish

Food Stamp Flyer

HIPAA Policy (English)

HIPAA Policy (Spanish)

HIPAA Policy (Creole)

ICWA Form

ICWA Form - Spanish

PBC Community Resources (2015)

Release of Medical Information - Parental Permission

Release of Medical Records - Children's Records

SACC Release Form

Water Safety Survey

HHS/Deaf and Hard of Hearing Forms

HHS CPI Checklist

HHS Sample Mockup Forms

Communication Assessment - Instructions

Communication Assessment (English)

Communication Assessment (Spanish)

Communication Assessment (Creole)

Customer Feedback (English)

Customer Feedback (Spanish)

Customer Feedback (Creole)

Request for Waiver (English)

Request for Waiver (Spanish)

Request for Waiver (Creole)

Operational Forms

Case Opening Document (2019)

Communication Assistance Request/Waiver

Diligent Search - Affidavit (Jan 2010)

Diligent Search - Request Form

Drug Testing & Counseling Referral Form

Emergency Intake - Psychotropic Medications Consent

Child Placement Agreement

Instructions for Fingerprinting Appointment

Firearm Acknowledgment Form

Grid Check Request

In-Home Non-Judicial Case Management Request Form

In-Home Non-Judicial Services Agreement

Mileage Log

Other Parent Home Assessment

Police Report Request

Relative/Non-Relative Caregiver Brochure (Level 1 Licensure Brochure)

Safe Sleep Flyer

School Confidentiality

Unified Home Study

Presumptive Drug Test Form

Referral Forms

FIT Parent Brochure (March 2016)

FIT Referral Form

FIT Team Referral Flyer

FIT Team Referral Process

Chrysalis Referral Form

Safety Methodology Information and Resources

Present Danger Assessment

Safety Plan Template

FFA worksheet Short Version

FFA Worksheet Long Version